No cough syrup for children under 2.

No cough syrup for children under 2, Centre warns after deaths in 2 states

---

Following the deaths of eleven infants in Madhya Pradesh and Maharashtra, the Directorate General of Health Services (DGHS) has issued advice warning against the usage of cough syrups in young children.

A multi-agency study into child fatalities in Madhya Pradesh and Rajasthan served as the basis for the report and the DGHS’s subsequent advisory.

DGHS Cough Syrup Advisory (The Warning)

• Regarding the usage of cough and cold drugs in children, the Union Health Ministry’s Directorate General of Health Services strongly advised all States and Union Territories to follow these guidelines:
• Children Under Two: Children under the age of two should not be prescribed or given cough or cold remedies.
• Children Under Five: It is typically not advised to give these drugs to children younger than five.
• The advice emphasises that the majority of children’s acute cough diseases are self-limiting, meaning they go away on their own. The initial line of treatment should be non-pharmacological, such as rest, supportive care, and drinking enough water.
• Prescribing protocol: Any usage of medication for older children must conform to the shortest effective duration, rigorous adherence to suitable dosage, close supervision, careful clinical evaluation, and avoidance of numerous drug combinations.

1. Madhya Pradesh (Chhindwara)

• Toll: Approximately nine children died in Chhindwara district due to acute kidney failure over a period of about a month (starting early September).
• Suspected Syrups: The deaths were initially linked to the consumption of cough syrups, specifically Coldrif and Nextro-DS.
• Initial Suspect: The initial suspicion was that the syrups were contaminated with toxic industrial chemicals like Diethylene Glycol (DEG) or Ethylene Glycol (EG), known to cause severe kidney damage.

2. Rajasthan

• Toll: Reports link two to three child deaths in Sikar and Bharatpur to complications after using a cough syrup.
• Suspected Syrup: The product was a Dextromethorphan-based formulation distributed under the state government’s free medicine scheme, manufactured by Kayson Pharma.

3. Official Laboratory Findings (Union Health Ministry)

A joint team from the National Centre for Disease Control (NCDC), National Institute of Virology (NIV), and Central Drugs Standard Control Organisation (CDSCO) visited the sites and conducted tests, with the following official results:

4. Additional Regulatory Measures
As a precaution, the Chhindwara municipal government outlawed the selling of Coldrif and Nextro-DS. While a thorough inquiry is conducted, the Rajasthani government has prohibited the sale and distribution of any items supplied by Kayson Pharma. The Tamil Nadu government also prohibited the sale of Coldrif syrup batch No. SR-13 after its own tests revealed potential contamination.

While the cause of death is still being investigated, the Union Health Ministry’s overall conclusion is that no DEG/EG contamination was discovered in the tested samples. However, the incidents made clear the necessity of rigorous adherence to safe and sensible prescribing practices for children’s cold and cough medications.